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What should GPs do to comply with the law on access to information?

Legislation to encourage more openness among public bodies comes into force soon, but it has implications for GPs too, as Dr Gerard Panting of the MPS explains

A new general right of access to all types of recorded information held by public authorities has been created by the Freedom of Information Act 2000. The Act is intended to promote greater openness among public authorities; but what, you may wonder, can it have to do with GPs, or anyone else in the healthcare sector for that matter?

The public authorities covered by the Act include Government departments, local authorities, the police, schools, colleges, universities and NHS bodies. And here is the rub: the definition of public authority under the Act includes individual NHS GPs, dentists, pharmacists and opticians.

The Freedom of Information Act, which was passed on 30 November 2000, is to be fully implemented by January 2005, but its provisions will be phased in. Public authorities have two main responsibilities under the Act. First, to produce a publication scheme – a guide to the information they hold that is publicly available; and second, to respond to individual requests for information, either by referring the applicant to the publication scheme or by providing a specific response.

As far as public authorities in the NHS are concerned, publication schemes must be submitted to the Information Commissioner for approval by 31 August 2003 and be in place by 31 October 2003. The duty to respond to individual enquiries will not come into force until January 2005.

Patients do, of course, already have access to data held about themselves under the Data Protection Act 1998. What the new Act does is to extend rights of access to other forms of more general information, and although there are some general exemptions, most of those do not apply when it comes to the health sector.

However, personal information accessible under the Data Protection Act by the subject of the data is excluded, as are requests for personal information about third parties without consent, which would breach the data protection principles.

Requests for information may be made by any "legal or natural” person – in other words, not just individuals but also organisations, including pressure groups. Applications must be made in permanent form which includes e-mail as well as more traditional forms of written correspondence.

A fee (yet to be determined but to be set out in subsequent regulations) will be payable. The application should set out the applicant’s details as well as details of the information sought.

Applicants have two related rights: First, to be told whether the information sought is held by the public authority and second, to receive that information, where possible in the manner requested. Applicants may also ask to inspect records.

The timescale for responding to enquiries is 20 working days unless the relevant fee is not paid, in which case the time limit will be extended until payment is received, up to a maximum of 3 months.

Publication schemes

A publication scheme is a complete guide to the information routinely published by each public authority. It describes the classes or types of information that the authority makes publicly available and provides a novel means of making information easily available to the public. Publication schemes are intended to promote publication of more information proactively and to develop a greater culture of openness.

One means of publishing the scheme is to make it available on the internet. However, as access to the internet is not universal, publication by this means alone would not fulfil public authorities’ responsibilities under the Act.

The BMA has now produced a draft publication scheme for GPs and the good news is that, in the main, the information that must be published by general medical practitioners probably already exists.

The draft publication scheme sets out the classes of information available including how the individual GP practice fits in to the overall structure of the NHS. It also gives details of the practice organisational structure and key personnel, the services provided, details about funding and expenditure, complaints and a copy of the complaints policy for the practice naming the person to whom any complaint should be addressed in the first instance. Also included are regular publications and information for the public, which may amount to little more than is already in the practice leaflet.

For more than 10 years GPs have had an obligation under their terms of service to publish practice leaflets, which should give essential information for patients (see Box 1, below).

Box 1: Information to include in a practice leaflet

Details about the GP including name and sex, medical qualifications, date and place of first registration

Information about whether the GP works alone, part-time or in partnership

Availability, including arrangements for cover when the GP is not available

Details of the appointments system, including how to obtain an urgent appointment or home visit

Arrangements for receiving and responding to patients’ comments and complaints

Geographical boundary of the practice area

Details of access for the disabled

Individual requests for information

How far is this new access to information likely to be extended in future? Could GPs face enquiries about the local policy on prescribing drugs such as sildenafil, or about referral for treatment to centres abroad? Might they be asked questions on the use of co-ops or deputising services out of hours? Or on compliance with referral requirements or publication of practice audit data, PACT data and the like?

All these issues could form the basis of legitimate individual requests for information following full implementation of the Act on 1 January 2005. To ease the burden, it is worth considering what extra information might be added to your publication scheme in due course to enable more routine enquiries to be dealt with in that way.

Enforcement

The Freedom of Information Act is enforced by the Information Commissioner whose role extends to promoting good practice, advising members of the public on their rights under the Act and enforcing compliance, as well as approving publication schemes.

Conclusion

The Freedom of Information Act is likely to be seen by most GPs as a burden that brings no discernible benefits.Whether that is right or wrong, it is a statutory requirement that must be complied with, and failure to do so will inevitably give rise to greater inconvenience and expense.